A small cyst of 6mm between the lumbar 4-5 spinous processes can be treated with medication, physiotherapy or surgery according to the degree of the disease and clinical manifestations. 1. If the patient does not have the corresponding clinical symptoms, usually no special treatment is needed, and regular review is sufficient. 2. If the patient develops symptoms, anti-inflammatory and analgesic drugs, such as ibuprofen extended-release capsules and amoxicillin, can be standardized under the guidance of the doctor to help relieve the symptoms. 3. Physical therapy may be able to promote the absorption and shrinkage of the cyst. However, regular review is still needed after physical therapy to check whether the cyst is relieved. 4. If the patient has obvious pain and other symptoms, the cyst may compress the surrounding nerve tissue or lead to bone destruction, then surgery may be needed to relieve the nerve compression. In conclusion, when a patient is clearly diagnosed with a 6mm cyst in the lumbar 4-5 interspinous process, it is recommended that he or she seeks professional treatment according to the patient’s condition.